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尼日利亚医生所穿白大褂导致医院感染传播的可能性:对改善患者安全举措的影响。

The potential for nosocomial infection transmission by white coats used by physicians in Nigeria: implications for improved patient-safety initiatives.

作者信息

Uneke C J, Ijeoma P A

机构信息

Department of Medical Microbiology/Parasitology, Faculty of Clinical Medicine, Ebonyi State University Abakaliki, Nigeria.

出版信息

World Health Popul. 2010;11(3):44-54. doi: 10.12927/whp.2010.21664.

Abstract

Microbiological analysis of swabs taken from the cuffs and pocket mouths of physicians' white coats in an acute care hospital showed that 91.3% of the coats had bacterial contamination. Specifically diphtheroids, Staphylococcus aureus and Gram-negative bacilli were isolated. In contrast, comparatively lower rates of bacterial contamination were observed on the white coats (1) of visiting physicians, (2) of the medical unit compared with the rest of the hospital, (3) that were less 1 year old, and (4) that were laundered daily. Further, the white coats of physicians who wore them only when seeing patients had significantly lower bacterial contamination than white coats of physicians who wore theirs during clinical and nonclinical duties (chi(2) = 4.99, df = 1, p < .05). In particular, white-coat cuffs had a higher bacterial load than the mouths of the pockets. The bacterial isolates were resistant to nearly all of the antibiotics tested; the most effective, however, was ciproflox. Results suggest that physicians' white coats may increase nosocomial infection transmission. Proper handling of white coats by physicians and other healthcare workers could minimize cross-contamination and improve patient safety by potentially reducing nosocomial infections.

摘要

对一家急症医院内科医生白大褂袖口和口袋口采集的拭子进行微生物分析显示,91.3%的白大褂存在细菌污染。具体分离出了类白喉杆菌、金黄色葡萄球菌和革兰氏阴性杆菌。相比之下,在以下几类白大褂上观察到的细菌污染率相对较低:(1)来访医生的白大褂;(2)与医院其他科室相比,内科的白大褂;(3)使用不到1年的白大褂;(4)每天清洗的白大褂。此外,仅在看诊时才穿白大褂的医生,其白大褂的细菌污染程度显著低于在临床和非临床工作时都穿白大褂的医生(卡方检验:χ(2)=4.99,自由度df = 1,p <.05)。特别是,白大褂袖口的细菌载量高于口袋口。分离出的细菌对几乎所有测试抗生素都具有耐药性;然而,最有效的是环丙沙星。结果表明,医生的白大褂可能会增加医院感染的传播。医生和其他医护人员正确处理白大褂,可以通过潜在减少医院感染来最大限度地减少交叉污染并提高患者安全性。

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